Healthcare Analyst IV

Medica • Minnetonka, MN

7d • Hybrid

About The Position

Medica is a nonprofit health plan with more than a million members that serves communities in Minnesota, Nebraska, Wisconsin, Missouri, and beyond. We deliver personalized health care experiences and partner closely with providers to ensure members are genuinely cared for. We're a team that owns our work with accountability, makes data-driven decisions, embraces continuous learning, and celebrates collaboration — because success is a team sport. It's our mission to be there in the moments that matter most for our members and employees. Join us in creating a community of connected care, where coordinated, quality service is the norm and every member feels valued. Why this role matters Our organizations growth, affordability, and experience goals depend on crisp, defensible analytics and insights. The Healthcare Analyst IV is the analytic subject matter expert – advising in both consulting roles and build roles on complex claims, eligibility, clinical, and provider data to support clear decisions on pricing, benefit design, network strategy, quality, and utilization management. You’ll partner with leaders across Product, Network, Clinical, Finance, and Sales to translate between dashboards and outcomes—and you’ll coach others along the way. This role aligns to the Healthcare Analyst IV remit to manage complex data and present recommendations to diverse technical and non-technical audiences.

Requirements

• Bachelor’s degree in Mathematics, Statistics, Economics, Actuarial Science, Data Analytics, Health Analytics or a related field.
• 7+ years of work experience beyond degree.
• 7+ years of progressive healthcare analytics experience.
• Expert-level SQL skills; working proficiency in SAS and/or Python/R.
• Strong experience analyzing health insurance claims and administrative data.
• Proven ability to communicate complex findings to both technical and non-technical audiences and influence outcomes.
• Ability to lead analyses and consult with Payer experience/expertise: Analysis on cost and utilization, trend drivers, leakage, steerage, site-of-care, and program ROI for Commercial lines (IFB, small group, ASO).
• Translate regulatory and market dynamics (e.g., parity, benefit changes, employer trends) into analytic hypotheses and measurable experiments.
• Partner with Quality and Population Health teams to connect quality measures (e.g., HEDIS-style metrics) to segment experience and outcomes where applicable.
• Experience with Snowflake and modern ETL frameworks.
• Advanced Power BI (DAX, Power Query) or Tableau (LOD expressions, data modeling) experience at scale.

Nice To Haves

• Payer experience across pricing, benefit design, product, or network performance; exposure to Medicare Advantage or Medicaid analytics is a plus.
• Familiarity with quality programs (HEDIS, CAHPS, Stars), risk adjustment, or value-based care analytics.
• Consulting toolkit including hypothesis framing, value sizing, stakeholder facilitation, and change adoption methodologies (e.g., Prosci/ADKAR).

Responsibilities

• Strategic Analytics Consulting & Relationship Leadership Establish and maintain strong, trusted relationships across Lines of Business (Commercial, Medicare, Medicaid) and Operational Lever functions (e.g., Product, Network, Clinical, Finance, Operations, Sales).
• Act as a strategic analytics consultant to business and operational leaders by deeply understanding each area’s objectives, performance drivers, and decision-making needs.
• Translate business strategies and operational goals into clear analytic problem statements, hypotheses, and success measures.
• Proactively identify opportunities where analytics can influence outcomes such as affordability, growth, quality, experience, and operational efficiency.
• Serve as a connector across analytics, data engineering, BI, and business teams, ensuring the right analytic approach, tools, and expertise are applied to each business question.
• Facilitate structured conversations with stakeholders to align questions, assumptions, tradeoffs, and actions, not just reports or dashboards.
• Present insights and recommendations in a way that enables leaders to make confident, data-informed decisions, adjusting depth and framing for technical and non-technical audiences.
• Analytics Platform Enablement, Integration & Maturity Build strong working knowledge of Medica’s data platforms, analytic tools, and delivery models, including data warehouses, BI tools, and advanced analytics capabilities.
• Increase visibility, access, and understanding of analytics tools and data assets across Lines of Business and Operational Lever teams.
• Support the maturation and integration of analytics capabilities by helping standardize approaches, improve reuse, and reduce duplicative or ad hoc analysis.
• Contributes to the development and evolution of analytics playbooks that define: Common business questions and decision types Recommended analytic methods and metrics Approved data sources and definitions Appropriate tools and delivery teams
• Help design and maintain an analytics portal or intake framework that: Guides business users from questions to the right analytics tools, methods, and support teams Clarifies when to use self-service BI, standardized reporting, advanced analytics, or consulting-led analysis Improves transparency into analytics availability, ownership, and turnaround expectations
• Partner with analytics leadership to identify gaps in data, tooling, skills, or processes and recommend practical improvements.
• Champion best practices in data quality, governance, documentation, and reproducibility to increase trust and adoption of analytics.
• Insight Delivery, Adoption & Impact Ensure analytics deliverables are not just produced, but used, by embedding insights into business rhythms such as planning cycles, operating reviews, and performance discussions.
• Support change and adoption by helping teams understand how to interpret results, apply insights, and measure impact.
• Track outcomes and stakeholder feedback to continuously improve analytic approaches, playbooks, and enablement tools.
• Mentor analysts and model a consulting-oriented mindset that emphasizes problem solving, clarity, and business impact over report production.

Benefits

• Medica offers a generous total rewards package that includes competitive medical, dental, vision, PTO, Holidays, paid volunteer time off, 401K contributions, caregiver services and many other benefits to support our employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level